Long-Term Aneurally Regenerated Skeletal Myofibers into Heart: How Long They Could Survive and Grow by Phasic Daily FES?

Tissue or Cell Cardiac Bioassists (Cardiac-Bio-Assists) are biological approaches to remedy to cardiac progressive insufficiency based on autologous tissue or cell transplantation. Some of the work-hypotheses are in pre-clinical evaluation (implants of embryonic myocardiocytes or Skeletal Muscle Ventricle, SMV), others are under preliminary (Dynamic Aortomyoplasty, and heart implants of myoblasts derived from skeletal muscle satellite cells or potential cardiomyogenic stem cells from bone marrow) or advanced clinical testing (Dynamic Cardiomyoplasty). When injected into myocardium satellite cell-derived myoblasts undergo cell death, but some proliferate, differentiate and fuse to myotubes, which then increase in size in spite of never being re-innervated by functional motoneurons. We will here discus data of longterm viability of aneurally regenerated muscle in experimental animals and in humans. Furthermore, we will provide new evidence that functional electrical stimulation (FES) allows growth of aneurally regenerated myofibers to almost normal values. If artificial synapses could be designed and developed (to restrict activation to satellite cell derived myofibers, and avoid potentially arrhythmogenic excitability of the surrounding myocardiocytes) FES of the myofibers could add systolic assistance to benefits of satellite cell cardiac bio-assists.